Sleep Apnoea and the Heart: A Large Randomized Trial
Obstructive sleep apnoea has long been linked to a higher risk of heart attacks and strokes, but a link is not proof that treating the apnoea helps. This large multicentre randomized controlled trial — published in the New England Journal of Medicine, one of medicine's most demanding journals — set out to test it directly in 2,717 adults aged 45 to 75 who already had coronary or cerebrovascular disease alongside moderate-to-severe sleep apnoea.
Participants were randomly assigned to receive CPAP therapy plus usual care, or usual care alone, after a one-week run-in on sham CPAP designed to weed out those who couldn't tolerate the device. Randomization on this scale is what lets a trial separate the effect of the treatment from everything else going on in patients' lives.
This matters because it places the airway squarely inside the cardiovascular story. Sleep apnoea isn't only a sleep problem — the repeated drops in oxygen and surges in stress hormones each night reverberate through the heart and blood vessels. A trial of this size and rigour is exactly the kind of evidence that moves disordered breathing from a niche concern to a whole-body health issue.
Key Findings
A multicentre randomized controlled trial assigned 2,717 adults with moderate-to-severe sleep apnoea and existing heart or vascular disease to CPAP plus usual care, or usual care alone.
The trial used a one-week sham-CPAP run-in, a rigorous design feature to identify adherent participants.
It is among the largest randomized tests of whether treating the airway protects the cardiovascular system.
We’re advocates, not clinicians. This is curated, sourced evidence to help you ask better questions — bring it to a professional you trust, not a substitute for their advice.
Help the mission
Share this evidence so more people can ask better questions.
Sign in and earn a point every time you share.